Articles: nerve-block.
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Randomized Controlled Trial Clinical Trial
Pharmacokinetics of 0.75% ropivacaine and 0.5% bupivacaine after ilioinguinal-iliohypogastric nerve block in children.
Blockade of the ilioinguinal and iliohypogastric nerves is a useful procedure in paediatric patients undergoing inguinal surgery. Bupivacaine 2 mg kg-1 has been recommended for this block. We compared the plasma concentrations of ropivacaine and bupivacaine following an ilioinguinal-iliohypogastric block. ⋯ Bupivacaine is more rapidly absorbed from the injection site and leads to higher plasma concentrations than ropivacaine.
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Randomized Controlled Trial Clinical Trial
Periprostatic nerve block gives better analgesia for prostatic biopsy.
To prospectively compare two local anaesthetic techniques for prostatic biopsies, which are usually taken with no anaesthesia; because multiple biopsy techniques are becoming more common and there is an increasing need for analgesia/anaesthesia during the procedure. ⋯ A periprostatic nerve block with 1% lignocaine was associated with significantly less pain during prostatic biopsy than was rectal lignocaine gel or placebo.
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The wide variety of peripheral blocks makes for a difficult endeavor in trying to grasp their many potential complications. However, the common features of these complications makes it possible to use the construct presented here, in combination with one's knowledge of anatomy, to be able anticipate many, if not most, of the complications of any particular peripheral regional anesthetic.
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Accidental intrathecal injection of bupivacaine during epidural analgesia in labour remains a hazard, with the potential to cause total spinal anaesthesia and maternal collapse. Sacral block appears early after intrathecal injections compared with epidural ones, and we therefore used SI motor block to determine a safe and reliable test dose for epidural catheter misplacement. ⋯ We conclude that testing for SI motor block 10 min after epidural injection of bupivacaine 10 mg is a reliable test to detect accidental intrathecal injection in the obstetric population.
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Epidural and spinal anesthesia enjoy wide usage in modern practice, and each can provide reliable and safe anesthesia. Although the techniques appear to the casual observer to require relatively straightforward technical skill, both are fraught with myriad hazards and potential complications. It is the familiarity with and the understanding of these complications that makes for safe and professional practice of these techniques.